Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt.
Department of Pathology and Electron Microscopy, Theodor Bilharz Research Institute, Cairo, Egypt.
Folia Morphol (Warsz). 2021;80(4):850-856. doi: 10.5603/FM.a2020.0119. Epub 2020 Oct 21.
Telocytes and Cajal cells have been described in human urinary tract and reproductive system in women and men. Telocytes and Cajal cells have been differentiated from other interstitial cells and were described to be an element in smooth muscle conductivity. Previous studies examined the ureteropelvic junction (UPJ) segment in patients with UPJ obstruction (UPJO) and attributed the aetiology of UPJO to the low density or absence Cajal cells and telocytes. The present work aimed at the demonstration of the presence and the density of telocytes and Cajal cells in the upper urinary tract (UUT) in cases with normal UUT and UPJO. It included UPJ segment, renal pelvis, and proximal ureter. The morphological pattern of distribution of collagen in relation to smooth muscle was investigated in normal and obstructed UUT.
The study was carried out on 12 surgical specimens, 5 of them represented the normal UUT and underwent nephrectomy for oncological reasons. Seven patients underwent dismembered pyeloplasty for UPJO. Surgical specimens included renal pelvis, UPJ segment, and proximal ureter. They were subjected to standard haematoxylin and eosin stain, Gomori's trichrome stain, immunohistochemistry with c-kit, and transmission electron microscopy.
Telocytes and Cajal cells were demonstrated in the muscular layer of both normal UUT and UPJO with high density in the proximal ureter in normal UUT as well as in UPJO. The UPJ segment in normal UUT had moderate density of Cajal cells and telocytes while in UPJO the cells were scanty or absent. Renal pelvis in normal UUT showed excess density of cells while obstructed renal pelvis showed scanty Cajal cells and telocytes. Ultrastructural study showed the presence of Cajal cells, telocytes, stem cells, fibroblasts, smooth muscle cells, and collagen in different densities and distribution in normal and obstructed UUT.
Examination of the UPJ segment of UPJO revealed that Cajal cells and telocytes were scanty or absent, collagen to muscle ratio was high. The low density of Cajal cells and telocytes in the renal pelvis of the obstructed UUT, compared to the normal, points out to the role of the renal pelvis in the pathogenesis of UPJO.
在女性和男性的人体泌尿道和生殖系统中已经描述了 Telocytes 和 Cajal 细胞。Telocytes 和 Cajal 细胞已从其他间质细胞中分化出来，并被描述为平滑肌传导的一个元素。先前的研究检查了肾盂输尿管连接部（UPJ）段在 UPJ 梗阻（UPJO）患者中，并将 UPJO 的病因归因于 Cajal 细胞和 Telocytes 的密度低或缺失。本研究旨在证明正常 UPJ 和 UPJO 患者上尿路（UUT）中 Telocytes 和 Cajal 细胞的存在和密度。它包括 UPJ 段、肾盂和近端输尿管。研究了正常和梗阻性 UUT 中胶原与平滑肌分布的形态模式。
这项研究是在 12 个手术标本上进行的，其中 5 个代表正常 UUT，并因肿瘤原因接受了肾切除术。7 名患者因 UPJO 接受了离断式肾盂成形术。手术标本包括肾盂、UPJ 段和近端输尿管。它们接受了常规苏木精和伊红染色、Gomori 三色染色、c-kit 免疫组织化学和透射电子显微镜检查。
在正常 UUT 和 UPJO 的肌肉层中均显示出 Telocytes 和 Cajal 细胞，在正常 UUT 的近端输尿管中也显示出高密度。正常 UUT 的 UPJ 段具有中等密度的 Cajal 细胞和 Telocytes，而 UPJO 中的细胞稀疏或缺失。正常肾盂中细胞密度过高，而梗阻性肾盂中 Cajal 细胞和 Telocytes 稀疏。超微结构研究显示，正常和梗阻性 UUT 中存在 Cajal 细胞、Telocytes、干细胞、成纤维细胞、平滑肌细胞和胶原，其密度和分布不同。
对 UPJO 的 UPJ 段进行检查显示，Cajal 细胞和 Telocytes 稀疏或缺失，胶原与肌肉的比例较高。与正常相比，梗阻性 UUT 肾盂中的 Cajal 细胞和 Telocytes 密度较低，提示肾盂在 UPJO 的发病机制中的作用。
